J O H N P A U L I I I N S T I T U T E F O R S T U D I E S O N M A R R I A G E A N D F A M I L Y at The Catholic University of America Michael J. McGivney Scholarship Program

Responsibility for securing the necessary financial resources rests with the student. Resources for a student's support include: a) earnings in part-time work; b) summer earnings (the Institute normally expects a student to provide at least $1,000 from summer employment); c) grants from churches and other sources (in those situations where it is appropriate, students are expected to seek financial assistance from their home church, diocese and other outside sources); d) savings (students are expected to use their savings and other liquid assets for their educational expenses); e) earnings of the spouse (when a student is married but has no children, the spouse who has completed his or her formal education is normally expected to be gainfully employed, and the spouse's total earnings are to be considered as a part of the total family income); f) support by family and friends (while the Institute recognizes the need and desire of students to become increasingly independent of support from parental sources, a contribution is expected where possible).

The Knights of Columbus provides a limited number of complete and partial scholarships in memory of its founder, Reverend Michael J. McGivney. These scholarships are awarded using competitive standards aimed at identifying those students with academic promise. To apply for a scholarship, you must provide the following information and write a short (200 words or less) essay on “Why you should be considered for a McGivney Scholarship." Please attach your essay to this scholarship application form.

Important details Scholarship deadline is January 31 for the coming academic year. All scholarship recipients must student full-time. Maximum coverage: MTS applicants, four semester; STL applicants, four semesters; STD four semesters; PhD ten semesters.

Name ______LAST FIRST MIDDLE Address______Telephone Home (______)______Work (______)______Date of Birth ______Place of Birth ______Nationality ______Social Security # ______Degree Program _____M.T.S. _____S.T.L. _____S.T.D. ____Ph.D. State in Life _____Religious _____Lay _____ Diocesan Clergy If married, is spouse a student? _____ If so, where ______Full-time _____Part-time

Is spouse employed? ______Employer______Position ______Wage/Annual Salary $______Will spouse be employed? ______Where? (if known) ______Are you employed? ______Employer ______Wage/Annual Salary: $______Position ______Will you be employed? ______Where? (if known) ______Financial Information Please list all available financial resources and estimated expenses for a nine-month period. Resources Expenses Net Income (nine months) ______Tuition $ _ 16,500_ Summer Savings ______Room and Board ______Parental Contribution ______Books and Fees _____1,000_ Spouse Contribution ______Travel ______Veteran's Benefits ______Other Expenses Grants or Loans ______(Please attach a separate Savings statement itemizing and ______explaining each expense) ______Other Income (specify) ______Total Expenses ______Total Income ______

Those who have worked for a number of years and who many have families are to include with this form a separate sheet which outlines the family budget along with your most recent tax return. Both resources and expenses for a nine-month period must be listed.

Previous Debt Undergraduate debt $______Graduate or seminary debt $______Source and amount of financial aid, if any, for your last school year: ______Academic Information Graduate Record Examination Scores Verbal _____ Quantitative _____ Writing ______Date to be taken ______Post-secondary Degrees Degree Major Institution Cumulative GPA ______Post-secondary scholarships, fellowships, academic awards, honors, etc. received: ______I hereby certify that the information given by me in this application is complete and accurate in every respect.

Signature______Date______